Safe Kids Worldwide report finds 1.35 million children seen in emergency rooms for sports-related injuries, including injuries from cheerleading. / Charlie Litchfield, AP

by Michelle Healy, USA TODAY

by Michelle Healy, USA TODAY

Occasional bumps and bruises are expected when kids play sports, but for more than 1.35 million children last year a sports-related injury was severe enough to send them to a hospital emergency department.

Sprains and strains, fractures, contusions, abrasions and concussions top the list of sports-related ER diagnoses for kids ages 6 to 19 - at a cost of more than $935 million each year, according to a report out Tuesday from the non-profit advocacy group Safe Kids Worldwide.

The report, which analyzed data for 2011 and 2012, did not find a statistical difference between the two years, but is concerning - one in five kids who go to ERs for treatment of an injury is there for sports injuries, says Kate Carr, Safe Kids president and CEO.

"Far too many kids are arriving in emergency rooms for injuries that are predictable and preventable," Carr says.

Using data from the U.S. Consumer Product Safety Commission's National Electronic Injury Surveillance System, the report focused on pediatric sports injuries related to 14 common sports activities, including football, cheerleading, soccer and basketball. More than 46.5 million children played team sports in 2011, says the report.

It finds that in 2012, 12% of all ER visits (163,670) involved a concussion, the equivalent of one every three minutes. Nearly half (47%) were in kids ages 12 to 15.

That's particularly troubling, given research showing that younger athletes take a longer time to heal than older athletes after a concussion, which is a traumatic brain injury, because their bodies are still growing, Carr says. "And we know that a second concussion later can cause even more issues."

Like previous studies, the new report shows that in sports in which both girls and boys participate, girls report a higher percentage of concussions. Among youth basketball players, for example, 11.5% of girls seen in the ER are diagnosed with concussions, compared with 7.2% of boys. Among soccer players, it's 17.1% of girls compared with 12.4% of boys.

It's unclear what accounts for the variation, says sports medicine physician Kathryn Ackerman, co-director of the Female Athlete Program at Boston Children's Hospital. "We are still looking into it, trying to see if there are really genetic differences, differences in play, or differences in biomechanics, but we don't have that link yet." Ackerman was not involved in the new study.

Although the number of injuries cited in the new report may seem high, the actual number is likely even higher, says Neeru Jayanthi, a sports medicine physician at Loyola University Medical Center in Chicago. That's because the study included only ERs, and many kids go to urgent care centers, their regular doctor or a sports medicine clinic, says Jayanthi, who was not involved in the study.

Nor do the figures highlight the significant number of overuse injuries, "about 25% of which end up being serious," he says. Overuse injuries to tendons, bones and joints can result from playing the same sport and performing the same movements too often, too hard or at too young an age with inadequate recovery time.

Research reported earlier this year by Jayanthi and colleagues found that young athletes who played a single sport for more hours a week than years they were old - such as a 10-year-old who played 11 or more hours of soccer - were 70% more likely to experience serious overuse injuries.

Letting the body rest, adding preventive and strengthening exercises, and following proper technique are among injury prevention strategies recommended in the new report. It also says athletes should be encouraged to speak up about injuries, coaches should be supported in injury-prevention decisions, and parents and young athletes should become better educated about sports safety.

"These statistics don't have to be part of the game if we take some simple precautions," Carr says.

Among other findings from the report:

â?¢ Football resulted in both the highest number of all pediatric injuries (394,350) and the highest concussion rate (40 per 10,000 athletes). Wrestling and cheerleading had the second- and third-highest concussion rates (15 per 10,000 athletes and 12 per 10,000 athletes, respectively).

â?¢ Ice hockey had the highest percentage (31%) of concussion injuries; its rate was 10 per 10,000 athletes.

â?¢ The most common injuries were to the ankle (15%), followed by head (14%) finger (12%), knee (9%) and face (7%).